Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-11-19
- Stop
- 2018-11-19
The parties
- Patient
- patient Phylis Elenora Cassin
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Humana
Record id
0400c40b-e8b5-c779-cc00-089686978860